I do not use antagonists in high responders (e.g., PCOS) because it
interferes with the assay of E2 (often causing the value to be
understated), a valuable index in assessing risk for the development
of severe/critical OHSS. I also do not believe in the agonist trigger
to prevent OHSS. The reason is that the magnitude of the induced LH
surge varies and if too little LH is released, meiosis can be
compromised, thereby increasing the oocyte aneuploidy index.

 
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